A Promising Therapy for Healing PTSD

When he left active duty, Brian Anderson, an Army Green Beret with 14 years of service, 33 months in combat and 3 Bronze Stars, started experiencing symptoms of post-traumatic stress disorder (PTSD).

“I started questioning my existence, whether I was alive, thinking I was in purgatory and thought I actually died in Afghanistan and had to right everything that went wrong,” said Anderson.

“I suffered from a lot of survivor’s guilt and was living in a real dark space. A lot of times it felt like I was in combat and I was chasing after an enemy combatant, but often times there was no one for me to chase. It was a real tough time. It sometimes felt like I was already six feet under and I was trying to get to the surface but I had no direction to crawl or dig.”

At the advice of a friend, Anderson underwent a session of accelerated resolution therapy (ART) at the University of South Florida. ART “is an evidence-based novel psychotherapy that fosters rapid recovery by reprogramming how the brain stores traumatic memories and imagery,” said Kelly Breeding, a clinical social worker and executive director of ART International Training and Research, Inc. It was developed by therapist Laney Rosenzweig, MS LMFT, in 2008.

During an ART session, a clinician leads the client through a set of horizontal eye movements to calm trauma-related physical and emotional sensations. (These movements are used in eye movement desensitization and reprocessing, or EMDR.) The client doesn’t recount the trauma to the therapist; they visualize it.

In his first session, Anderson focused on September 29, 2010, when Calvin and Mark, two of his military brothers, were killed by a high-ranking Taliban commander. He focused on the details of that day: getting the call that his friends were being held in a machine gun nest, taking out the machine gun nest, finding the Taliban commander, and seeing that his friends were dead.

Next the therapist and client work on incorporating new information and images into the existing memories. “ART allows a client to essentially become the director of their memory or imagery,” Breeding said. “One of my favorite examples used by an ART clinician is that a client is able to take an ‘R-rated’ image and change it to a ‘G-rated’ image.”

For instance, Anderson focused on this image: eating Afghan food and chatting while sitting in a circle with Calvin and Mark, their Afghan counterparts and some village elders. Mark calls in several Black Hawks to bring Calvin Burger King because he didn’t like to eat Afghan food.

The clinician also asks the client to visualize a future situation that might trigger the traumatic memory or negative feelings and they help them eliminate those sensations, Breeding said. For example, if a client was in a car crash, they visualize themselves driving on a busy street or highway, and process those sensations, she said.

For Anderson, some of the images he used to regularly see (and feel) have dissipated: “Calvin driving the car next to me, Mark walking past me in the mall, images of bullets going through my head or rage coming through the door.”

In addition to treating trauma, ART may be effective for suicidal ideation. According to Breeding, “Nonpsychotic suicidal ideation often results from feelings of hopelessness, intense despair and intense emotions. The use of eye movements allows a client to calm and control the thought patterns that are leading to or contributing to the suicidal thoughts.”

ART helps individuals shift their perspective to make positive choices and have clear decision-making, which “often involves shifting the focus and emotions off themselves and on to the distressing event,” Breeding said.

In 2015, the National Registry of Evidence-Based Programs and Practices, part of the Substance Abuse and Mental Health Services Administration, found ART to be an effective psychotherapy for PTSD, depression, stress, and personal resilience, Breeding said. It’s also being used in U.S. Army hospitals, including Walter Reed and Fort Belvoir, she said.

Thus far, the research on ART has been limited, but it’s found promising results. For instance, a 2012 study found that 79 percent of participants who initially screened positive for PTSD screened negative after completing about four sessions of ART. A 2013 study found that ART reduced symptoms of PTSD, depression, anxiety and trauma-related guilt in U.S. service members and veterans. (You can learn more about the research in this published review.)

Currently, the University of Cincinnati Gardner Neuroscience Institute is conducting a randomized controlled trial comparing the effectiveness of ART with cognitive processing therapy (CPT) for PTSD in both the military and civilian population. According to Breeding, it will take 3 years to complete and includes 280 participants who will be randomly assigned to treatment. Preliminary findings will be released this January.

Today, Anderson is the founder of Veterans Alternative, a non-profit organization that provides services to combat veterans and their spouses. After his initial session of ART, he participated in several more sessions “for survivor’s guilt and other stories.” After his last deployment, he suffered a traumatic brain injury. He still gets hypervigilant from time to time. But he’s able to breathe through it and calm down. Most of his PTSD symptoms have significantly diminished.

“For me, ART is about a perspective shift,” Anderson said. “Instead of looking at the past, I’m able to be more present here, in the future and going forward—and it’s quite amazing.”

“Our lost warriors are always looking for something. We wake up and we’re in this fog that just stays with us. It’s wondering what your left and right is, what forward is, what back is, you just have no direction in life. It’s a difficult process. ART is the most effective therapy that I’ve found to allow you to live above the clouds and start seeing some direction in life to reach that azimuth.”

PTSD is complex and persistent, and can steal years from a person’s life. Since different therapies work for different people, it’s vital to have a variety of truly effective treatments. And although more research is needed, ART may be a promising option to add to that list.